Groton Community Health Care CTR Res Care Fac

In the surveyor’s words

From the most serious findings on record at Groton Community Health Care CTR Res Care Fac, in the surveyor’s own words.

• Immediate jeopardy, widespreadF689Dec 4, 2024

  Based on observations, record review, and interviews during the recertification and extended surveys conducted 11/21/2024-12/4/2024, the facility failed to ensure the residents' environment remained free of accident hazards 2 of 2 resident units (First and Second Floors). Specifically, hot water temperatures in resident sinks and common shower rooms on the First and Second Floors exceeded temperatures of the 110 degree Fahrenheit standard. This resulted in no actual harm with likelihood of serious harm, serious injury, serious impairment, or death that is Immediate Jeopardy and Substandard Quality of Care for all 70 residents residing in the facility. […]

• Immediate jeopardy, patternF700Dec 4, 2024

  Based on observations, record review, and interviews during the recertification and extended surveys conducted 11/21/2024-12/4/2024, the facility failed to ensure correct installation, use, and maintenance of bed rails to ensure there was no gap between the bed rail and mattress wide enough to entrap a resident's head or body for 5 of 5 residents (Residents #2, #14, #29, #33, and #46) reviewed. Specifically, Resident #2's bed was against the wall, with one bed rail and no bracket to hold the mattress in place (mattresses with bedrails should have a bracket or device to hold the mattress on the frame and in place. This is the component that keeps the mattress snugly against the rail. The bracket could be a strap around the end. or an actual raised metal bar. […]

• Actual harm, isolatedF686Dec 4, 2024

  Based on observations, record review, and interviews during the recertification and abbreviated (NY00322525 and NY00322126) surveys conducted 11/21/2024-12/4/2024, the facility did not ensure a resident received care, consistent with professional standards of practice, to prevent pressure ulcers for 1 of 1 resident (Resident #30) reviewed. Specifically, Resident #30 experienced a decline in physical mobility and developed an unstageable pressure wound (full thickness tissue loss in which the base of the ulcer is covered with non-viable tissue) and cellulitis to their heel. There was no documented evidence that preventative measures were implemented to prevent skin breakdown when the resident's mobility declined. […]

• No harm, potential for more than minimal, widespreadF584Dec 4, 2024

  Based on record review, observations, and interviews during the recertification and abbreviated (NY00359606) surveys conducted 11/7/2024-12/4/2024, the facility did not ensure residents had a safe, clean, comfortable, and homelike environment for 2 of 2 nursing units. Specifically, there was no hot water in the facility from 10/29/2024-11/8/2024. Additionally, resident's or resident representatives were not immediatley notified of the lack of hot water. Findings include: The undated facility policy, Safety of Water Temperatures, documented tap water in the facility should be kept within a temperature range to prevent scalding of residents. […]

• No harm, potential for more than minimal, widespreadF812Dec 4, 2024

  50561 Based on observations, record review, and interviews during the recertification survey conducted [DATE]-[DATE] the facility did not store, distribute, and serve food in accordance with professional standards for food service safety in the main kitchen and for 1 of 1 resident (Resident #34) reviewed. Specifically, Resident #34's food was handled directly by staff without the use of gloves. In the main kitchen foods in the kitchen walk-in cooler were not properly labeled; floors had debris and uncleanable surfaces; there were unclean surfaces and equipment; walls were in disrepair; and the dishwasher sanitizer was not maintained at the vendor recommended level. […]